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Hand (New York, N.Y.) Sep 2020Carpal tunnel syndrome and ulnar neuropathy are such common maladies affecting the upper extremties that they often become the default diagnosis when patients complain... (Review)
Review
Carpal tunnel syndrome and ulnar neuropathy are such common maladies affecting the upper extremties that they often become the default diagnosis when patients complain of numbness, pain, or weakness of the hands. While often correct, there are a number of other conditions that can also cause sensory or motor loss of the hands, which should be considered when appropriate, as they can mimic upper extremity entrapment syndromes. In this review, we will discuss such mimics, including Charcot-Marie-Tooth disease, multifocal motor neuropathy, hereditary neuropathy with pressure palsies, mononeuropathy multiplex, Lewis-Sumner syndrome, brachial plexitis (Parsonage-Turner syndrome), myotonic dystrophy, inclusion body myopathy, and distal myopathy of Welander. We will discuss the clinical presentation, as well as diagnostic testing, treatment (if available), and prognosis. The objective is to provide a differential diagnosis for those patients who do not fit well clinically or respond to usual therapy for entrapment neuropathy of the upper extremities.
Topics: Brachial Plexus Neuritis; Carpal Tunnel Syndrome; Humans; Nerve Compression Syndromes; Ulnar Neuropathies; Upper Extremity
PubMed: 32020820
DOI: 10.1177/1558944719898801 -
Scientific Reports Apr 2017The present study was performed to explore the role of galanin and galanin receptor 2 in nociceptive modulation in anterior cingulate cortex (ACC) of normal rats and...
The present study was performed to explore the role of galanin and galanin receptor 2 in nociceptive modulation in anterior cingulate cortex (ACC) of normal rats and rats with mononeuropathy. Intra-ACC injection of galanin induced significant increases in hindpaw withdrawal latencies (HWLs) to thermal and mechanical stimulations in both normal rats and rats with mononeuropathy, the increased HWLs were attenuated significantly by intra-ACC injection of galanin receptor 2 antagonist M871, indicating an involvement of galanin receptor 2 in nociceptive modulation in ACC. Interestingly, the galanin-induced HWL was significant higher in rats with mononeuropathy than that in normal rats tested by Randall Selitto test. Furthermore, both the galanin mRNA expression and galanin content increased significantly in ACC in rats with mononeuropathy than that in normal rats. Moreover, both the mRNA levels of galanin receptor 2 and the content of galanin receptor 2 in ACC increased significantly in rats with mononeuropathy than that in normal rats. These results found that galanin induced antinociception in ACC in both normal rats and rats with mononeuropathy. And there may be plastic changes in the expression of galanin and galanin receptor 2 in rats with mononeuropathy, as well as in the galanin-induced antinociception.
Topics: Animals; Galanin; Gene Expression; Gyrus Cinguli; Hindlimb; Male; Mononeuropathies; Nociception; Nociceptive Pain; Nociceptors; Pain Measurement; Peptides; Protein Precursors; Rats, Sprague-Dawley; Receptor, Galanin, Type 2
PubMed: 28378856
DOI: 10.1038/srep45930 -
Postgraduate Medical Journal Jan 2007Cubital tunnel syndrome is the second most common peripheral nerve entrapment syndrome in the human body. It is the cause of considerable pain and disability for... (Review)
Review
Cubital tunnel syndrome is the second most common peripheral nerve entrapment syndrome in the human body. It is the cause of considerable pain and disability for patients. When appropriately diagnosed, this condition may be treated by both conservative and operative means. In this review, the current thinking on this important and common condition is discussed The recent literature on cubital tunnel syndrome was reviewed, and key papers on upper limb and hand surgery were discussed with colleagues.
Topics: Cubital Tunnel Syndrome; Diabetic Neuropathies; Humans; Referral and Consultation; Risk Factors
PubMed: 17267675
DOI: 10.1136/pgmj.2006.047456 -
Clinical Medicine (London, England) 2004Mononeuropathies can be mistaken for other neurological problems. Most mononeuropathies can be diagnosed clinically. The time course and mechanism of peripheral nerve... (Review)
Review
Mononeuropathies can be mistaken for other neurological problems. Most mononeuropathies can be diagnosed clinically. The time course and mechanism of peripheral nerve injury determine the approach to investigation and treatment. The type of nerve injury determines the potential for recovery. Acute mononeuropathies can be the presentation for vasculitis.
Topics: Diagnosis, Differential; Humans; Mononeuropathies
PubMed: 15139726
DOI: 10.7861/clinmedicine.4-2-113 -
Scandinavian Journal of Work,... Jan 2009The aim of this study was to make a quantitative assessment of the exposure-response relationships between work-related physical and psychosocial factors and the... (Review)
Review
OBJECTIVES
The aim of this study was to make a quantitative assessment of the exposure-response relationships between work-related physical and psychosocial factors and the occurrence of carpal tunnel syndrome (CTS) in occupational populations.
METHODS
A systematic review of the literature was conducted on the associations of type of work, physical load factors, and psychosocial aspects at work to the occurrence of CTS. The associations between work factors and CTS were expressed in quantitative measures, namely, odds ratios (OR) or relative risks.
RESULTS
Jobs with the highest risk of CTS included work in the meat- and fish-processing industry, forestry work with chain saws, and electronic assembly work (OR 76.5, 21.3, and 11.4, respectively). The occurrence of CTS was associated with high levels of hand-arm vibration, prolonged work with a flexed or extended wrist, high requirements for hand force, high repetitiveness, and their combination. No association was found between any psychosocial risk factor and CTS. Contradictory findings were reported for associations between computer work and CTS.
CONCLUSIONS
This review provides consistent indications that CTS is associated with an average hand force requirement of >4 kg, repetitiveness at work (cycle time 50% of cycle time performing the same movements), and a daily 8-hour energy-equivalent frequency-weighted acceleration of 3.9 m/s2.
Topics: Carpal Tunnel Syndrome; Cumulative Trauma Disorders; Female; Humans; Male; Occupational Exposure; Psychology
PubMed: 19277433
DOI: 10.5271/sjweh.1306 -
Diagnostic and Interventional Imaging Jan 2017The complications following surgery for lung cancer vary depending upon the comorbidities and the type of surgery. Hemorrhage, infections and pulmonary edemas are not... (Review)
Review
The complications following surgery for lung cancer vary depending upon the comorbidities and the type of surgery. Hemorrhage, infections and pulmonary edemas are not specific to the type of resection but frequently occur following pneumonectomies. Morbidity following pneumonectomies is related to the significant changes in the contents of the intrathoracic space. Pulmonary infarction and torsion are emergency situations that develop following lobectomy. CT shows features of localized congestion and stenosis or occlusion of a vein or bronchus. Rapid identification of severe events, in particular by systematic CT is essential for appropriate management of a postoperative or delayed complication of lung cancer surgery.
Topics: Arterial Occlusive Diseases; Chylothorax; Diaphragm; Empyema, Pleural; Foreign Bodies; Heart Diseases; Hernia; Humans; Lung Neoplasms; Mononeuropathies; Neoplasm Recurrence, Local; Phrenic Nerve; Pneumonectomy; Postoperative Complications; Pulmonary Edema; Pulmonary Embolism; Pulmonary Infarction; Torsion Abnormality
PubMed: 26342532
DOI: 10.1016/j.diii.2015.06.022 -
Muscle & Nerve Jul 2019We assessed the potential use of quantitative ultrasound (QUS) in the evaluation hand muscles affected by upper extremity mononeuropathies.
INTRODUCTION
We assessed the potential use of quantitative ultrasound (QUS) in the evaluation hand muscles affected by upper extremity mononeuropathies.
METHODS
The gray scale levels (GSLs) of abductor pollicis brevis (APB), abductor digiti minimi (ADM), and first dorsal interosseous (FDI) of 30 healthy and 30 upper extremity mononeuropathy patients were measured and compared with standard electrophysiological values.
RESULTS
Mean GSL was elevated in 34 APBs of carpal tunnel syndrome patients and 18 FDIs of ulnar neuropathy patients (e.g., FDI mean GSL (interquartile range) 31.5 (27.3~43.8) arbitrary units for patients and 24.0(23.0~29.0) for healthy subjects (P = 0.020)). GSL correlated with motor response amplitudes (Spearman's rho (ρ) = -0.39, P = 0.002 in APB, ρ = -0.72, P = 0.002 in FDI, and ρ = -0.43, P = 0.013 in ADM). The APB GSL correlated with electromyographic severity and disease duration (ρ = 0.46, P < 0.001 and ρ = 0.45, P = 0.003).
CONCLUSIONS
Muscle QUS may serve as a useful tool in upper extremity mononeuropathy evaluation. Further study of this concept is recommended.
Topics: Aged; Carpal Tunnel Syndrome; Case-Control Studies; Elbow; Female; Hand; Humans; Male; Middle Aged; Mononeuropathies; Muscle, Skeletal; Neural Conduction; Prospective Studies; Ulnar Neuropathies; Ultrasonography
PubMed: 30942930
DOI: 10.1002/mus.26481 -
Deutsches Arzteblatt International Sep 2019
Topics: Humans; Peroneal Neuropathies
PubMed: 31617488
DOI: 10.3238/arztebl.2019.0643b -
Turkish Neurosurgery 2022To evaluate the effects of factors, which are associated with carpal tunnel syndrome (CTS) prevalence, on disease severity.
AIM
To evaluate the effects of factors, which are associated with carpal tunnel syndrome (CTS) prevalence, on disease severity.
MATERIAL AND METHODS
This retrospective study included 206 patients who were treated surgically for either moderate or severe CTS. Patients were grouped into moderate and severe CTS then compared regarding to age, gender, BMI, and presence of occupational factors as well as systemic diseases that are associated with CTS.
RESULTS
Patients with moderate and severe CTS did not differ in age, gender, occupational risk factors, and most of the systemic diseases, including DM, hypothyroidism, rheumatoid arthritis, cardiovascular disease, renal insufficiency, and folate deficiency. The severe CTS group had a significantly higher BMI than the moderate CTS group. Moreover, vitamin B12 deficiency was significantly more common in the severe CTS group than in the moderate CTS group.
CONCLUSION
Patients with severe CTS are more inclined toward surgery than those with moderate CTS. Controlling BMI and preventing vitamin B12 deficiency may help keep alleviate complaints related to CTS with less invasive treatment modalities.
Topics: Carpal Tunnel Syndrome; Humans; Retrospective Studies; Risk Factors; Severity of Illness Index; Vitamin B 12 Deficiency
PubMed: 34859834
DOI: 10.5137/1019-5149.JTN.34519-21.2 -
The Keio Journal of Medicine Jun 2008Peroneal neuropathy is one of the common focal mononeuropathies in the lower extremities occurring in both adults and children. Foot drop due to weakness of ankle... (Review)
Review
Peroneal neuropathy is one of the common focal mononeuropathies in the lower extremities occurring in both adults and children. Foot drop due to weakness of ankle dorsiflexion is the most common presentation of a peroneal neuropathy. It may also result from other causes involving the upper or lower motor neurons. Disorders that must be distinguished from peroneal neuropathy include sciatic mononeuropathy, lumbosacral plexopathy, motor neuron disease, polyneuropathy, and an L5 radiculopathy. To establish a diagnosis, electrodiagnostic studies have been used to localize the level of the abnormality and to establish prognosis. The most common site of injury is the fibular head, but focal neuropathies have also been reported at the level of the calf, ankle, and foot. In this article, we overviewed the peroneal nerve palsy, and its diagnosis by neurophysiologic evaluation, conduction study and needle EMG. The neurophysiologic information gives us the underlying pathophysiology and its prognosis. Therefore the neurophysiologic evaluation must be performed not only for the differential diagnosis, but also for planning the treatment strategy.
Topics: Central Nervous System; Electrophysiology; Humans; Neurophysiology; Peroneal Neuropathies; Prognosis
PubMed: 18677088
DOI: 10.2302/kjm.57.84